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Selenium: childhood poisoning and cystic fibrosis
Insights
Selenium supplementation poses a risk for children with cystic fibrosis, potentially causing low serum chloride and severe health issues. Overdoses can be particularly dangerous for this vulnerable population.
Area of Science:
- Pediatric Medicine
- Toxicology
- Nutritional Science
Background:
- Cystic Fibrosis (CF) is a genetic disorder affecting multiple organs, particularly the lungs and digestive system.
- Selenium is an essential trace element, but excessive intake can lead to toxicity.
- Health food fads sometimes promote high-dose supplements without adequate safety data.
Observation:
- Two pediatric cases of selenium ingestion are presented, both with a history of cystic fibrosis.
- Both children exhibited low serum chloride levels concurrently with selenium use.
- One child presented with dehydration and protein-calorie malnutrition, factors that can exacerbate selenium toxicity.
Findings:
- Selenium ingestion in children with cystic fibrosis is associated with electrolyte imbalances, specifically low serum chloride.
- The study suggests a potential link between selenium supplementation and increased morbidity and mortality in children with CF.
- Factors like malnutrition may enhance selenium's toxic effects in this patient group.
Implications:
- Selenium should be used with extreme caution, if at all, in children with cystic fibrosis.
- High-dose selenium supplementation, especially as a health fad, presents a significant hazard for pediatric CF patients.
- Further research is needed to elucidate the mechanisms of selenium toxicity in CF and establish safe supplementation guidelines.
Abstract:
Two cases of selenium ingestion in children are described; one child with severe cystic fibrosis died. Both children had cystic fibrosis and both had low serum chloride in association with selenium usage. Neither child was exposed to excessive heat or cold weather, factors known to salt-deplete children were cystic fibrosis, although one child was dehydrated during a summer month on initial presentation. One child had protein-calorie malnutrition, a condition known to enhance selenium toxicity in animals. We conclude that selenium is a potential hazard in its use as a health food fad for children with cystic fibrosis and in overdose ingestions. Thus selenium supplementation may have contributed to the morbidity and mortality reported here.